Evaluation of Local Recurrence of Pancreatic Cancer by KRAS Mutation Analysis Using Washes from Endoscopic Ultrasound-Guided Fine-Needle Aspiration

Kazuyuki Matsumoto, Hironari Kato, Kazuhiro Nouso, Soichiro Ako, Hideaki Kinugasa, Shigeru Horiguchi, Yosuke Saragai, Saimon Takada, Shuntaro Yabe, Shinichiro Muro, Daisuke Uchida, Takeshi Tomoda, Hiroyuki Okada

Research output: Contribution to journalArticle

Abstract

Background and Aims: The sensitivity of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) for diagnosing the recurrence of pancreatic cancer is usually low because of difficulties in obtaining adequate samples for pathological examinations. We evaluated the efficacy of highly sensitive KRAS mutation analysis using EUS-FNA washes to detect cancer recurrence. Methods: Nineteen consecutive patients with suspected pancreatic cancer recurrence after surgical resection were enrolled. All underwent EUS-FNA, and samples were obtained for pathological examination. After the first session, the inside of the FNA needle was washed with saline for DNA extraction. KRAS mutations were examined using digital droplet PCR (dPCR). Results: The median needle puncture number used to obtain adequate pathological samples was two (range 1–6). In ten patients pathologically diagnosed with malignant pancreatic cancer, nine patients tested positive for a KRAS mutation. All patients who were not diagnosed with a malignant pancreatic cancer tested negative for a KRAS mutation. About half of surgically resected primary cancers (9/19) showed double KRAS mutations (G12V and G12D); however, all but one wash sample showed a single KRAS mutation, G12D. After including one patient who showed a malignant recurrence during follow-up, the sensitivities of a pathological diagnosis and KRAS analysis to detect recurrence were 90.9% and 81.8%, respectively. Conclusions: KRAS mutation analysis of needle wash samples using dPCR is a new methodology for the diagnosis of the local recurrence of pancreatic cancer. The diagnostic ability of dPCR with a one-time needle wash sample was comparable to a pathological diagnosis with multiple samplings.

Original languageEnglish
JournalDigestive Diseases and Sciences
DOIs
Publication statusAccepted/In press - Jan 1 2020

Fingerprint

Endoscopic Ultrasound-Guided Fine Needle Aspiration
Pancreatic Neoplasms
Recurrence
Mutation
Needles
Polymerase Chain Reaction
Punctures
Neoplasms
DNA

Keywords

  • Digital PCR
  • EUS-FNA
  • KRAS mutation
  • Local recurrence
  • Pancreatic cancer

ASJC Scopus subject areas

  • Physiology
  • Gastroenterology

Cite this

Evaluation of Local Recurrence of Pancreatic Cancer by KRAS Mutation Analysis Using Washes from Endoscopic Ultrasound-Guided Fine-Needle Aspiration. / Matsumoto, Kazuyuki; Kato, Hironari; Nouso, Kazuhiro; Ako, Soichiro; Kinugasa, Hideaki; Horiguchi, Shigeru; Saragai, Yosuke; Takada, Saimon; Yabe, Shuntaro; Muro, Shinichiro; Uchida, Daisuke; Tomoda, Takeshi; Okada, Hiroyuki.

In: Digestive Diseases and Sciences, 01.01.2020.

Research output: Contribution to journalArticle

@article{38dae9218af745b588aa33ea9b01d89e,
title = "Evaluation of Local Recurrence of Pancreatic Cancer by KRAS Mutation Analysis Using Washes from Endoscopic Ultrasound-Guided Fine-Needle Aspiration",
abstract = "Background and Aims: The sensitivity of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) for diagnosing the recurrence of pancreatic cancer is usually low because of difficulties in obtaining adequate samples for pathological examinations. We evaluated the efficacy of highly sensitive KRAS mutation analysis using EUS-FNA washes to detect cancer recurrence. Methods: Nineteen consecutive patients with suspected pancreatic cancer recurrence after surgical resection were enrolled. All underwent EUS-FNA, and samples were obtained for pathological examination. After the first session, the inside of the FNA needle was washed with saline for DNA extraction. KRAS mutations were examined using digital droplet PCR (dPCR). Results: The median needle puncture number used to obtain adequate pathological samples was two (range 1–6). In ten patients pathologically diagnosed with malignant pancreatic cancer, nine patients tested positive for a KRAS mutation. All patients who were not diagnosed with a malignant pancreatic cancer tested negative for a KRAS mutation. About half of surgically resected primary cancers (9/19) showed double KRAS mutations (G12V and G12D); however, all but one wash sample showed a single KRAS mutation, G12D. After including one patient who showed a malignant recurrence during follow-up, the sensitivities of a pathological diagnosis and KRAS analysis to detect recurrence were 90.9{\%} and 81.8{\%}, respectively. Conclusions: KRAS mutation analysis of needle wash samples using dPCR is a new methodology for the diagnosis of the local recurrence of pancreatic cancer. The diagnostic ability of dPCR with a one-time needle wash sample was comparable to a pathological diagnosis with multiple samplings.",
keywords = "Digital PCR, EUS-FNA, KRAS mutation, Local recurrence, Pancreatic cancer",
author = "Kazuyuki Matsumoto and Hironari Kato and Kazuhiro Nouso and Soichiro Ako and Hideaki Kinugasa and Shigeru Horiguchi and Yosuke Saragai and Saimon Takada and Shuntaro Yabe and Shinichiro Muro and Daisuke Uchida and Takeshi Tomoda and Hiroyuki Okada",
year = "2020",
month = "1",
day = "1",
doi = "10.1007/s10620-019-06006-6",
language = "English",
journal = "American Journal of Digestive Diseases",
issn = "0002-9211",
publisher = "Springer New York",

}

TY - JOUR

T1 - Evaluation of Local Recurrence of Pancreatic Cancer by KRAS Mutation Analysis Using Washes from Endoscopic Ultrasound-Guided Fine-Needle Aspiration

AU - Matsumoto, Kazuyuki

AU - Kato, Hironari

AU - Nouso, Kazuhiro

AU - Ako, Soichiro

AU - Kinugasa, Hideaki

AU - Horiguchi, Shigeru

AU - Saragai, Yosuke

AU - Takada, Saimon

AU - Yabe, Shuntaro

AU - Muro, Shinichiro

AU - Uchida, Daisuke

AU - Tomoda, Takeshi

AU - Okada, Hiroyuki

PY - 2020/1/1

Y1 - 2020/1/1

N2 - Background and Aims: The sensitivity of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) for diagnosing the recurrence of pancreatic cancer is usually low because of difficulties in obtaining adequate samples for pathological examinations. We evaluated the efficacy of highly sensitive KRAS mutation analysis using EUS-FNA washes to detect cancer recurrence. Methods: Nineteen consecutive patients with suspected pancreatic cancer recurrence after surgical resection were enrolled. All underwent EUS-FNA, and samples were obtained for pathological examination. After the first session, the inside of the FNA needle was washed with saline for DNA extraction. KRAS mutations were examined using digital droplet PCR (dPCR). Results: The median needle puncture number used to obtain adequate pathological samples was two (range 1–6). In ten patients pathologically diagnosed with malignant pancreatic cancer, nine patients tested positive for a KRAS mutation. All patients who were not diagnosed with a malignant pancreatic cancer tested negative for a KRAS mutation. About half of surgically resected primary cancers (9/19) showed double KRAS mutations (G12V and G12D); however, all but one wash sample showed a single KRAS mutation, G12D. After including one patient who showed a malignant recurrence during follow-up, the sensitivities of a pathological diagnosis and KRAS analysis to detect recurrence were 90.9% and 81.8%, respectively. Conclusions: KRAS mutation analysis of needle wash samples using dPCR is a new methodology for the diagnosis of the local recurrence of pancreatic cancer. The diagnostic ability of dPCR with a one-time needle wash sample was comparable to a pathological diagnosis with multiple samplings.

AB - Background and Aims: The sensitivity of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) for diagnosing the recurrence of pancreatic cancer is usually low because of difficulties in obtaining adequate samples for pathological examinations. We evaluated the efficacy of highly sensitive KRAS mutation analysis using EUS-FNA washes to detect cancer recurrence. Methods: Nineteen consecutive patients with suspected pancreatic cancer recurrence after surgical resection were enrolled. All underwent EUS-FNA, and samples were obtained for pathological examination. After the first session, the inside of the FNA needle was washed with saline for DNA extraction. KRAS mutations were examined using digital droplet PCR (dPCR). Results: The median needle puncture number used to obtain adequate pathological samples was two (range 1–6). In ten patients pathologically diagnosed with malignant pancreatic cancer, nine patients tested positive for a KRAS mutation. All patients who were not diagnosed with a malignant pancreatic cancer tested negative for a KRAS mutation. About half of surgically resected primary cancers (9/19) showed double KRAS mutations (G12V and G12D); however, all but one wash sample showed a single KRAS mutation, G12D. After including one patient who showed a malignant recurrence during follow-up, the sensitivities of a pathological diagnosis and KRAS analysis to detect recurrence were 90.9% and 81.8%, respectively. Conclusions: KRAS mutation analysis of needle wash samples using dPCR is a new methodology for the diagnosis of the local recurrence of pancreatic cancer. The diagnostic ability of dPCR with a one-time needle wash sample was comparable to a pathological diagnosis with multiple samplings.

KW - Digital PCR

KW - EUS-FNA

KW - KRAS mutation

KW - Local recurrence

KW - Pancreatic cancer

UR - http://www.scopus.com/inward/record.url?scp=85077256649&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85077256649&partnerID=8YFLogxK

U2 - 10.1007/s10620-019-06006-6

DO - 10.1007/s10620-019-06006-6

M3 - Article

AN - SCOPUS:85077256649

JO - American Journal of Digestive Diseases

JF - American Journal of Digestive Diseases

SN - 0002-9211

ER -